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CMS issues 2026 MA and Part D proposed rule

Wed, 12/04/2024

Revenue Integrity Insider

Coverage, News, Policies and Procedures, Revenue Integrity

Review CMS' proposed policy and technical changes to Medicare Advantage (MA) and Part D programs for 2026.

How to boost your professional network

Tue, 11/26/2024

Revenue Integrity Insider

Revenue Integrity

A strong professional network is key to growing as a revenue integrity professional and moving your career forward. Learn about current and upcoming opportunities.

Q&A: Defining outpatient CDI processes

Tue, 11/26/2024

Revenue Integrity Insider

Ask NAHRI, Coding and Documentation, Revenue Integrity

Q: What clinical documentation integrity (CDI) methods should be used in the outpatient setting?

OIG to analyze skin substitute payments, incident-to billing, HRAs

Wed, 11/20/2024

Revenue Integrity Insider

Monitoring and Audits, News, Revenue Integrity

Review recent additions to the Office of Inspector General's (OIG) Work Plan, which often indicate areas of noncompliance.

Mastering denials management: Strategic insights for revenue cycle leaders

Fri, 11/15/2024

Leadership Council Insider

Coding and Documentation, Denials and Appeals, NAHRI Leadership Council, Revenue Integrity

by Alba Kuqi, MD, MSHIM, RHIA, CCM, CRCR, CICA, CSMC, CSAF, CCS, CCDS, CDIP

MSSP changes in the 2025 MPFS final rule

Wed, 11/13/2024

Revenue Integrity Insider

News, Policies and Procedures, Reimbursement and Payment Methodologies, Revenue Integrity

After publishing the 2025 Medicare Physician Fee Schedule (MPFS) final rule, CMS provided more information on upcoming changes to the Medicare Shared Savings Program (MSSP).

CMS makes changes to behavioral health, new codes, and cuts to rates in 2025 MPFS final rule

Wed, 11/06/2024

Revenue Integrity Insider

Billing and Claims, Chargemaster and Charge Capture, Coding and Documentation, Compliance, Coverage, News, Reimbursement and Payment Methodologies, Revenue Integrity

Organizations must prepare for a slew of new codes and billing updates for Part B payment, according to the 2025 Medicare Physician Fee Schedule (MPFS) final rule. The final rule, released November 1, details CMS’ numerous changes to payment rates, billable services, telehealth rules, and other services.